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Abstract
Twenty-seven patients with locally advanced and inoperable bladder carcinoma (LABCa)
were referred for chemotherapy. All were staged by cytoscopy, examination under anesthesia,
and computed tomography (CT), and 18 also had bipedal lymphangiography (LAG). In 16
patients (56%), there was agreement between the clinical and the CT staging of the
primary bladder tumor. In four of these 16 patients, CT detected lymphadenopathy in
three and demonstrated pelvic bone invasion in one. Of the remaining 11 patients,
CT underestimated the local extent of the bladder tumor in nine and over-estimated
in two. Lymphangiography was abnormal in nine patients (50%), in four of whom the
abnormality was not seen on CT scan. Among the ten patients with normal LAG, six had
abnormal pelvic nodes detected by CT. The LAG affected the overall staging of the
tumor in five patients (16.6%). The total incidence of nodal metastasis as seen on
CT, LAG, or both was 72%. Although CT and LAG may not add significantly to the clinical
staging of the primary tumor in LABCa, they will affect the overall staging of the
tumor by detecting lymphadenopathy. Accurate staging of these patients is important
because, with aggressive chemotherapy, some of these patients might become candidates
for more radical treatment such as surgery or radiotherapy.
Keywords
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© 1988 Published by Elsevier Inc.
